Family Paths Facilities Rental Payment Form

FACILITIES RENTAL PAYMENT FORM

If you would like to make a payment for space/room rental at Family Paths, you can do so using this form. You will need a credit card or a debit card with a Visa or Mastercard logo on it.
In order to complete this form, you will need:

Your credit card number, expiration date, CVV code
The date of your rental
The amount of your agreed upon fee per Facilities Manager, Shay Black

If you have any questions about your fee, please contact Shay Black at sblack@familypaths.org.

Full Name of Payer*

First NameLast Name

Name of Company/Agency, if any.

Which type of payment are you making?*

Which dates are you paying for?*

What is your fee (per month or per room rental), as agreed upon by Shay Black, Facilities Manager?*

My Payment*

USDEnter Amount

Credit/Debit Card Payment

E-mail*

Phone Number*

Area CodePhone Number

Message